CCHIT Truly Independent?
The Certification Commission for Health Information Technology (CCHIT) came under fire again in February. Blogs were buzzing about its board’s conflicts of interest and the fact that its certification process favors large EMR vendors (because only they can afford the hefty certification fees).
You can find some of these posts and comments on the Clinical IT Blog, The Health Care Blog, and the Health Care Renewal Blog.
So, What Do You Think? – Is CCHIT too conflicted to do a proper job of certifying EMR vendor offerings? Should CCHIT revise is certification fees (lower fees for all vendors, adopt scaled fees tied to trailing-year vendor revenue, etc.), thereby leveling the playing field for EMR vendors? Is all of this discussion moot because CCHIT is now irrelevant (ONCHIT and NIST will take the lead to develop HIT infrastructure and EMR certification standards)?
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Tags: CCHIT, CCHIT Bias, CCHIT Biased, CCHIT Board Conflicts, CCHIT Conflict Of Interest, CCHIT Corrupt, CCHIT Favors Large Vendors, CCHIT Independence, CCHIT Not Independent, Certification Commission for Health Information Technology, Conflict of Interest, Corruption, Excessive Certification Fees, HiMSS, HiMSS And CCHIT Conflicts, Is CCHIT Biased
Michael, as a preface, let me say that I do not discount the value of CCHIT\’s work thus far. Someone had to take the bull by the horns and make a start, and CCHIT is to be commended for its effort in that regard (alleged conflicts of interest, etc., aside).
As for CCHIT\’s longer-term role, I believe that the federal government needs to step up and establish substantive standards and corresponding certification criteria. There are some things that simply cannot (and should not) be accomplished in the private sector. And, this time around, there may (I said MAY) be enough political will to get something accomplished.
In terms of the aggressive timelines in the stimulus package, the fed will need to act quickly and decisively. The fed could certainly adopt some of CCHIT\’s existing certification criteria, as well as develop additional meaningful criteria, but only after the most sensible standards have been established. Standards first, then certification criteria. If sufficent progress toward standards and certification has not made in the coming months, the \"meaningful EHR user\" reimbursement schedule could always be moved back (delayed). There has been much discussion about \"cart before horse\" with the HIT portion of the stimulus bill, and I for one agree that we won\’t get the greatest value from the $20B to be spent unless we have a meaningful end game in sight. Spending dollars to merely to increase the overall size of the mish-mash of existing dysfunctional HIT components won\’t help anyone in the long term.
After the fed lays down the law, then we will start to see some real progress toward increasing efficiencies and saving health care dollars. The various health care players, including EMR and related app\’ developers, public- and private-sector payors, providers, TPAs, etc., will have their marching orders. We\’ll see greater competition among EMR and related app\’s providers, and the pricing will come down. All EMR providers have been wasting money chasing the standards tail, and many smaller providers have not been able to carry through the trumoil and gain traction for their offerings, forcing them to go out of business or merge with a rival. In my opinion, fed-mandated standards (and corresponding certifications) will level the playing field for many health care players and start to move us in the right direction. Not a panacea, and with much more work to be done and many tough decisions to be made, but a clear step in the right direction.
I am curious why you feel that CCHIT will be forgotten. What mechanism is in place to “certify” vendors? I believe that under the time line provided by the wording in the Stimulus bill will not provide enough time for anyone other than CCHIT to be the certification body for EMR.
What else do you propose?
I think you hit the nail on the head. CCHIT has become irrelevant. All this talk of conflict, bias, and borderline corruption makes for interesting discussions (especially for the conspiracy theorists among us, including myself!), but its only value is entertainment. The feds have left the door open for a continuing role for CCHIT, but my guess is that CCHIT will be soon forgotten.